Provider Demographics
NPI:1528024791
Name:MOLDENHAUER, ZENDI (PHD, RN, CPNP/NPP)
Entity Type:Individual
Prefix:DR
First Name:ZENDI
Middle Name:
Last Name:MOLDENHAUER
Suffix:
Gender:F
Credentials:PHD, RN, CPNP/NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 W BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9202
Mailing Address - Country:US
Mailing Address - Phone:585-582-1312
Mailing Address - Fax:
Practice Address - Street 1:61 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-1067
Practice Address - Country:US
Practice Address - Phone:585-748-0943
Practice Address - Fax:585-624-4415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3811521363LP0200X
NYF4008021363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY110217EUOtherPREFERRED CARE